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THE

BRITISH AND FOREIGN

MEDICO-CHIRURGICAL REVIEW.

JANUARY, 1873.

Analytical and Critical Reviews.

I. The Public Health Act, 1872.

THE statutory result of recent discussions on sanitary legislation is wholly incommensurate with the zeal and ability displayed by the controversialists. Foregone conclusions have been accepted instead of inductions from facts; and facts have been recklessly denied, because there has been no thorough sifting of statements. On either side of this controversy a large scheme has been rejected because a part of it was open to question, and an instalment has been declined because it was an incomplete measure.

Our last article on the subject (January, 1872) was written in a hopeful strain. Mr. Stansfeld's Bill had not then appeared. We had some reason to suppose that, uncommitted as he was to any official project, his acute and independent though somewhat crotchetty mind might have discarded the fundamental errors which we pointed out in the scheme of the Sanitary Commission, and in Sir C. B. Adderley's Bill founded thereon; and we hoped that the Government measure, however limited in scope, would have enacted nothing to impede more precise and comprehensive legislation hereafter. For it would be absurd to expect that a single act, or even several acts in a single session, could meet all the requirements of a complete code of public health; and it must be confessed that Mr. Stansfeld's original measure, imperfect as it confessedly was, showed an advance, a decided amendment, upon that of the Chairman of the Royal Commission, as regards local authorities. For it did not, as that did, propose to perpetuate all the small and troublesome areas of representative management which have been so unwisely created under former sanitary acts. The "Special Drainage Districts," each governed by its petty elective board, are now to be dissolved, absorbed in larger districts, and converted into

101-LI.

1

"contributory places." This is as it should be. If the same bold sweep had been made of half the local board districts, the benefit to social progress and to the public health would probably have been doubled.

Nearly a fourth of the existing local board districts contain less than 3000 inhabitants. Scarcely more than a fourth contain 10,000 and upwards. Yet the weight of evidence before the Commission went to show that no place with a population of less than 10,000 or 12,000 ought to be isolated from the general management of the country for the purpose of separate health administration. Mr. Thring, the eminent counsel at the Home Office, whose knowledge of sanitary law was probably greater than that of any member of the Commission, and whose authoritative statements and forcible arguments in favour of county sanitary administration were lost upon the prejudiced minds to whom they were addressed, advised (358-9) that only very large towns (100,000 or 200,000 population) would require special legislation; and again (378), that a town with 200,000 or 300,000 inhabitants might be treated as a county. These important recommendations were made nearly four years ago. How little fruit have they borne! How long and apparently hopeless the task of educating the legislative mind!

One remarkable fallacy in the work of the Commission has been their assumption that every small body, constituted for local government, must be empowered to execute, not only the common functions of keeping order and promoting decency and cleanliness, but also the higher functions of sanitary administration. Here, as elsewhere-latet dolus in generalibus. The inefficiency of the smaller local boards having been proved, Mr. Stansfeld at first proposed to take power to dissolve districts with less than 3000 population in default of duty. He would have done more wisely if, without actually dissolving the lesser local governments, he had included them all by representation in a County Board, or at least in a Council managing an entire Registration District. Incapable, as it appears, of appreciating the difference between ordinary local government and sanitary local management, he has retained unlimited power to form for sanitary purposes, districts without restriction as to size, and local boards without regard to competency. On the whole, it is clear that, while the new Act favours the multiplication of these minute and often mischievous urban isolations of authority, it contains no adequate powers to merge them, for health objects, in wider and more suitable districts.

Another strange error in this new constitution of local sanitary authorities is, that no provision has been made for the combination, or at least compulsory co-operation, of the esta

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